PIEDMONT HOSPITAL ICUs

A visit to the Red (Open Heart CCU), Green (NICU), and Blue Units (Med Surg.) with a comparison to a Regular Hospital Room

Host: Patricia BlackGroup Members: Wanlin Xiang, Siming Mao, Ann Rogers, Kushal Waghmare

Red• Open Heart (CCU)• 10 rooms, 5 on each side of a central nursing

station.• Configured for maximum storage of supplies

both within patient room and outside• Sleeping discouraged (no family area)• Quiet• Ample ambulatory space for nurses

Green• Neuro ICU • Designed in the 70s in a circular plan, intended for maximum

visibility• Renovated recently to improve visibility and work: 10 rooms 8

• Cited by Ms. Black as more problematic than rectangular layout due to difficulty in aligning rectilinear furniture

• Observed by team members: • Less space for nurse alcoves• More restricted ambulatory space• Disorienting

Blue

• Med-Surg.• Same layout as ICU red• 10 rooms instead of 12

Regular Patient Room• No Visibility• Inboard toilet in the room• Large window >> More natural light• Difficult to renovate: Wiring embedded in concrete walls make

rewiring difficult• Expensive glass doors

Problems at Piedmont noted by Ms. Black

• Monitoring:• Too many machines to nurse: “I’d rather be talking to them

or washing their hair, etc.” – Charting:

• Too much time spent charting• Charting often done long after observations are made• Charting done on hands

– Nurses don’t want to spend as much time in the room as Ms. Black wants them to.

• Family inclusion versus intrusion• Technologies don’t “talk” to one another• Building is land-locked, so expansion is difficult• Noise of TVs

Problems our group will focus on:“Design for better visibility”

1. It is difficult and expensive to renovate existing designs– For ICUs (circle layout)– Non-ICUs being renovated to become ICUs

2. The hospital desires to include families in the care process but they interrupt nurse workflow and make them uncomfortable to be observed (causing pain to the patient, e.g.)

3. Nurses don’t get to spend as much time in direct contact with the patient as is desired

1. Because of charting difficulties2. Because of the profusion of machines

Ideas for solutionsRetrofit Visibility

• Reduction in the number of roomsICU Green (Piedmont): Originally had 10

rooms, which were reduced to 8• Using Cameras, Mirrors• Rectangular design of the unit• Outboard toilets and less storage in the room• More glass, more windows

Normalizing the round layout

Bathroom

Family Storage

*Depends on available space

Ideas for Solutions:Family inclusion v. intrusion

• Headphones• Lighted nametag color coded to indicate

availability

Ideas for solutions:Patient face time

and charting/routine tasks

• Exterior wall-mounted display with touch-screen representation of patient body

• Shoulder mounted audio recording device

• Automated Charting

Thank you